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Instability of eating disorder diagnoses: prospective study

  • Gabriella Milos (a1), Anja Spindler (a1), Ulrich Schnyder (a1) and Christopher G. Fairburn (a2)
Abstract
Background

The stability of eating disorder diagnoses has received little research attention.

Aims

To examine the course of the full range of clinical eating disorders.

Method

A sample of 192 women with a current DSM–IV eating disorder (55 with anorexia nervosa, 108 with bulimia nervosa and 29 with eating disorder not otherwise specified) were assessed three times over 30 months using a standardised interview.

Results

Although the overarching category of ‘eating disorder’ was relatively stable, the stability of the three specific eating disorder diagnoses was low, with just a third of participants retaining their original diagnosis. This was due only in part to remission since the remission rate was low across all three diagnoses.

Conclusions

There is considerable diagnostic flux within the eating disorders but a low overall remission rate. This suggests that underpinning their psychopathology may be common biological and psychological causal and maintaining processes.

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Copyright
Corresponding author
Dr G. Milos, Department of Psychiatry, University Hospital, Culmannstr. 8, 8091 Zurich, Switzerland. Tel: + 411 255 52 80; fax: + 411 255 45 30; e-mail: gabriella.milos@usz.ch
Footnotes
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Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Instability of eating disorder diagnoses: prospective study

  • Gabriella Milos (a1), Anja Spindler (a1), Ulrich Schnyder (a1) and Christopher G. Fairburn (a2)
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eLetters

To Vomit or Not to Vomit?

Yasir Abbasi, SHO in Child and Adolescent Psychiatry
22 December 2005

This prospective study about the ‘instability of eating disorder diagnoses’ seems quite appealing and attention-grabbing to the reader. It particularly interested me because we currently have several patients diagnosed with Anorexia Nervosa at our adolescent inpatient unit.

Even though they all seem to be recuperating with time, but they are still far from showing a diagnostic flux at the moment. One patient, surprisingly, doesn’t show the classical ‘distorted body image’ symptom currently but still continues to make herself sick. On numerous occasion she has mentioned to be vomiting as acts of self harm (she also cuts herself superficially at regular intervals) and continues to feel that it is a coping mechanism for her under undue stress. She is currently on no medication and we have managed to increase and maintain her weight in the past four months above 45 kg successfully with the help of the nurses, dietician and occupational therapist on the unit.

My question here is, would we still consider her diagnoses as Anorexia Nervosa or are we seeing a diagnostic flux into a completely different dimension of personality problems?
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Conflict of interest: None Declared

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